Tonsillar Calcification, Computed Tomography and Clinical Findings, A Case Study

Introduction : Tonsillar calcification or tonsil stones (tonsilloliths) are foul smelling lumps of whitish or yellowish color. They are usually asymptomatic but can be associated with halitosis and bad taste, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. They are a common incidental imaging finding in adults, especially in computed tomography (CT). Aim of the Work : This is a case study about palatine tonsillar and nasopharyngeal calcifications which require awareness from radiologists, especially in patients with clinical symptoms and signs which may suggest their presence. Material and Methods: The routine CT studies done for paranasal sinuses or the neck were carefully inspected for presence of tonsillar and/or adenoids calcification. Positive cases with incidentally found calcifications were referred for evaluation by the ear, nose and throat specialists. Results : Incidental calcifications were found in 31 patients; 30 of them had tonsilloliths and only one patient had calcification within the adenoids remnants without concomitant palatine tonsillar calcification. Conclusion : Tonsilloliths are tiny stones lodged in the pharyngeal tonsils, incidentally discovered during CT examinations. The awareness of the presence of these calcifications is important for the radiologists to avoid overlooking of these pathological entities which could be of clinical value.